Tag: treatment hierarchy

The Modified Low Dye

A physical therapy band-aid for foot pain during running Running-related injuries are commonly seen for physical therapy at Smith Performance Center. Unlike some of the advice, you may hear, stopping can prolong the problem.  Rest does not automatically equal recovery or resolution of an injury.  A nice tool to consider learning is the modified low dye.  It can help to reduce foot and lower leg pain while allowing you to continue training. Where is it from? I learned about the modified low dye from Dr. Tom McPoil.  He is faculty at Regis University and was previously faculty at Northern Arizona.  He is an expert on the foot and wrote an article on tissue stress theory that still impacts my practice today.  The purpose of the modified low dye in a physical therapy program is to limit stresses to the tissue of the lower leg and foot to allow desensitization. In

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The 5 Patient Responses That Should Impact Your Physical Therapist’s Strategy

In a session, the first rule as a practitioner is to make sure we do not lie to ourselves about what’s happening, and lying to ourselves is the easiest thing to do. We can lie to ourselves when we make errors in reasoning due to a plethora of cognitive pitfalls like confirmation or optimism bias, overconfidence, or mistaken availability heuristics. This can ruin the chances of a great outcome if I only search for facts that confirm my dominant theory, or if I want the patient to have a great response so I ignore portions of the medical history that would lead me to a think of worse prognosis. These cognitive errors ‘help’ me to lie to myself. One solution is to get very clear on what the patient is reporting. There are only 5 patient responses in the session: great, good, bad, terrible, and no response. Certain pathologies readily

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5 Treatment Options to Reduce Knee Pain without Surgery, Injections, or Drugs

We treat intractable knee pain on a daily basis. Our process is called the PT Solutions Treatment Hierarchy. The treatment hierarchy allows our team to support the diagnosis, reduce pain, and create a clear home plan. Building a treatment framework is a critical component of the plan and it changes based on the key sign, the structural diagnosis, and the trigger management plan.  For example, a person with an anterior horn meniscus lesion, we would first normalize painful end range extension of the knee.  Once passive extension is pain free, we would start to load their leg with the activity that normally hurts, providing them an exercise like terminal knee extension with the band that will keep their knee extension pain free.  Finally we would dig through all of their daily activities that cause symptoms like fast walking or going downhill and stop them from doing it to allow healing.

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Bracing for Groin Pain

A useful brace to compress and reduce pain in the adductor muscles   Bracing, Taping, and Training Aids Home Page Bracing, Taping, and Training Aids   Bracing for poor hip control The SERF Strap   Bracing for foot and lower limb control The Post Tib Brace   Taping for the Foot Modified Low Dye  

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How & When to Use a SERF Strap

What is the SERF Strap? The SERF Strap is the first patellofemoral brace designed to treat PFP due to poor hip control. Basically, the strap is a really long elastic band that you anchor at the knee (my term is foundation 1), tension over the outside of the thigh, and anchor around the pelvis (foundation 2). When you create these anchor points, the strapped leg will now have support for external rotation at the hip joint.  This reduces pelvic drop and knee valgus.  You can take someone whose knees hit together and immediately correct this dysfunction. While the marketing material and websites talk just about patellofemoral pain, I use this tool for symptoms in the leg (sometimes the back) during the stance phase of running or walking. This includes injuries like posterior tibialis tendinopathy, adductor longus and gluteus medius injury, and trochanteric bursitis. For athletes, I prescribe it as an

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Craig Smith

Craig Smith

BUSINESS Craig Smith is the co-owner of Smith Performance Center. He founded SPC with Sarah Smith in 2015 with a mission to provide the Tucson community with the support and tools to manage their health and stay active for life. He is a partner with Evolve Flagstaff. Founded in 2017, Evolve brings together gym, physical therapy, nutrition, and meal preparation services to support the Flagstaff community. Craig Smith founded Amptimum with Ryan Seltzer in 2020. Their mission is to unleash the clinical skill set of allied health professionals by developing documentation mastery, patient management processes, and robust analytics. WORK As a physical therapist, Craig is interested in physical therapy concepts with clinical application, PT diagnostic methodology, innovative healthcare solutions, and team-based practice. He specializes in lower extremity care, gait analysis, and physical therapy. As clinical director, Craig works to develop a shared framework for his physical therapy and coaching team. The shared framework, called PT Solutions and the HHP Program, is carried out daily with hundreds of patients and members. As a consultant, Craig works with allied health professionals to understand their clinical processes. This focus allows for clinicians to optimize their operations and to improve their clinical outcomes, train new staff, and reduce the burden of practice. AWARDS Craig graduated from NAU with distinction and was awarded the Distinguished Graduate for the Department. He graduated with honors from the University of Nebraska at Kearney and was awarded the Outstanding Major of the Year in Exercise Science by NAHPERD. Most recently, he was awarded the Excellence in Achievement from Northern Arizona by the NAU Alumni Association in 2020. RESEARCH Craig has presented research at the American Society of Biomechanics National Conference, the American College of Sports Medicine Annual Meeting, and the National NEXT conference along with numerous local and regional meetings on topics surrounding injury screening and prevention. He has publications in the Journal of Strength and Conditioning Research, Journal of Athletic Training, Journal of Orthopedic and Sports Physical Therapy, Medicine and Science in Sports and Exercise, Journal of Sports Medicine, and Lower Extremity Review. Craig and his colleagues, Dr. Warren and Dr. Chimera, were selected as one of the “Best Clinic Case/Research Submissions” at the 60th Annual Meeting and 4th World Congress on Exercise is Medicine of the American College of Sports Medicine.
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